Nuclear imagers adjust to to practice without Mo-99

Nuclear imagers are using alternatives to keep their practices alive until the National Research Universal Reactor at Chalk River, ON, resumes production of Mo-99. The shutdown has disrupted 60% of radiopharmacies in the U.S., according to an online survey jointly sponsored by the SNM and the National Association of Nuclear Pharmacies.

Only a third of respondents said they have an alternate source of Mo-99/Tc-99m generators, namely manufacturers with access to isotopes produced in reactors outside of North America. About 84% have eluted older generators more often to draw off as much technetium isotope as possible; 82% are using thallium-201 for cardiac imaging; 6% are performing F-18 FDG-PET bone imaging; and about 9% have shifted to F-18 sodium fluoride (NaF). Indium-111 (5%), gallium-67 (2%), and nitrogen-14 ammonia (1%) were also cited as alternatives.